右偏头痛。鼻窍流涕。仍不通爽。咽喉疳腐。寤醒肢冷汗出。外邪头风。已留
数月。其邪混处。精华气血。咸为蒙闭。岂是发散风寒可解。头巅药饵。务宜清扬。
当剌风池风府。投药仍以通法。莫非气血周行。焉望却除宿病。
西瓜衣 鲜芦根 苡仁 通草 蜡矾丸
头形象天。义不受浊。今久痛有高突之状。似属客邪蒙闭清华气血。然常
饵桂附河车。亦未见其害。思身半以上属阳。而元首更为阳中之阳。大凡阳气
先虚。清邪上入。气血瘀痹。其痛流连不息。法当宣通清阳。勿事表散。以艾KT 烙按
法灸治。是一理也。
熟半夏 北细辛 炮川乌 炙全蝎 姜汁
阳气为邪所阻。清空机窍不宣。考周礼采毒药以攻病。藉虫蚁血中搜逐。
以攻通邪结。乃古法而医人忽略者。今痛滋脑后。心下呕逆。厥阴见症。久病延
虚。攻邪须兼养正。
川芎 当归 半夏 姜汁 炙全蝎 蜂房
风温从上而入。风属阳。温化热。上焦进肺。肺气不得舒转。周行气阻。致身
痛脘闷不饥。宜微苦以清降。微辛以宣通。医谓六经。辄受羌防。泄阳气。劫胃汁。
温邪忌汗。何遽忘之。
杏仁 香豉 郁金 山栀 栝蒌皮 蜜炒橘红
劳倦嗔怒。是七情内伤。而温邪感触。气从口鼻直自膜原中道。盖伤寒阳
症。邪自太阳次第传及。至于春温夏热。则鼻受气。肺受病。口入之气。竟由脘中。
所以原有手经见症。不比伤寒足六经之病也。其原不同。治法亦异。仲景论温
邪不可发汗。汗则劫津伤阴。身必灼热。一逆尚引日。再逆促命期。又云。鼻息鼾。
语言难出。剧则惊痫螈 。无非重劫津液所致。今病发热。原不是太阳客邪见
症。所投羌防。辛温表汗。此误即为逆矣。上窍不纳。下窍不便。亦属常事。必以攻
下希图泄热。殊不知强汗劫津而伤阳。妄下劫液更亡阴。顷诊脉。两手如搐而
战。舌干燥而无苔。前板齿干。目欲瞑。口欲开。周身灯照而淡晦。斑纹隐隐约约。
几日来时有呃逆。因胃乏谷气而中空。肝阳冲突。上冒肆虐耳。为今返正。先与
糜粥。使胃中得濡。厥阳不致上冒。而神昏之累可已。进药之理。甘温可以生津
除热。即斑疹亦不足虑。观仲景论中。邪少虚多。阴液阳津并涸者。复脉汤主之。谨仿此义。
炙甘草 人参 生地 白芍 阿胶 麦冬
温邪有升无降。经腑气机交逆。营卫失其常度。为寒热。津液日耗。渴饮不
饥。阳气独行。则头痛面赤。是皆冬春骤暖。天地失藏。人身应之。患此者最多。考
古人治温病忌表。误投即为劫津。逆传心包。最怕神昏谵语妄狂。治病以辛甘
凉润为主。盖伤寒入足经。温邪入手经也。上润则肺降。不致 郁。胃热下移。知饥渴解矣。
嫩竹叶 桑叶 杏仁 蔗汁 麦冬 生甘草 石膏
久患虚损。原寝食安舒自服阴柔腻补。不但减食不寐。脘中常闷。渴欲饮
凉。此口鼻吸入温邪。先干于肺。误补则邪愈炽。气机阻塞。弱质不敢开泄。援引
清扬肃上。兼以威喜丸。淡以和气。上焦得行。可用养胃法。
白沙参 苡仁 天花粉 桑叶 郁金 威喜丸
积劳伤阳卫疏。温邪上受。内入乎肺。肺主周身之气。气窒不化。外寒似战
栗。其温邪内郁必从热化。今气短胸满。病邪在上。大便泻出稀水。肺与大肠表
里相应。亦由热迫下泄耳。用辛凉轻剂为稳。
杏仁 枯梗 香豉 橘红 枳壳 薄荷 连翘 茯苓
温邪中自口鼻。始而入肺为咳喘。继传膻中则呛血。乃心营肺卫受邪。然
邪在上焦。壅遏阻气。必聚为热。痰臭呛渴。是欲内闭。惜不以河间三焦立法。或
谓伤寒主六经。或谓肺痈。或泄气血。致热无出路。胸突腹大。危期至速矣。即有
对症药饵。气涌沸腾。势必涌吐无余。焉望有济。夫温热秽浊。填塞内窍。神识昏
迷胀闷欲绝者。须以芳香宣窍。佐牛黄金箔。深入脏络。以收锢闭之邪。今危笃
若此百中图一而已。
紫雪丹
仲景云。阴气先伤。阳气独发。不寒瘅热。令人消烁肌肉。条例下不注方。但
曰。以饮食消息之。后贤谓甘寒生津。解烦热。是矣。今脉数。舌紫渴饮。气分热邪
未去。渐次转入血分。斯甘寒清气药中。必佐存阴。为法中之法。
生地 石膏 生甘草 知母 粳米 竹叶心 白芍
温邪逆传膻中。热痰蔽阻空窍。所进寒凉消导。徒攻肠胃。毫无一效。痰乃
热熏津液所化。膻中乃空灵之所。是用药之最难。至宝丹。芳香通其神明之窍
以驱热痰之结。极是。但稚年受温邪。最易亏阴津耗。必兼滋清。以理久伏温邪为正。
犀角 鲜生地 元参 连翘心 丹皮 石菖蒲 至宝丹
腹满已久。非是暴症。近日面颔肿胀。牙关紧闭。先有寒热。随现是象。诊脉
右搏数。左小。乃温邪触自口鼻。上焦先受。气血与热胶固。致清窍不利。倏有痹
塞之变。理当先治新邪。况头面咽喉结邪。必辛凉轻剂以宣通。若药味重浊。徒
攻肠胃矣。仿东垣普济消毒意。
连翘 牛蒡子 马勃 射干 滑石 夏枯草 金银花露 金汁
脉左数。右缓弱。阳根未固。阴液渐涸。舌赤微渴。喘促自利。溲数。晡刻自热。
神烦呓语。夫温邪久伏少阴。古人立法。全以育阴祛热。但今见症。阴分固有伏
邪。真阳亦不肯收纳。拟仿刘河间浊药轻投。不为上焦热阻。下焦根蒂自立。冀
其烦躁热蒸渐缓。
熟地炭 茯苓 淡苁蓉 远志炭 川石斛 五味子
丰腴体质。适值过劳。阳气受伤。呕吐食物。无头痛身热。已非外感风寒。而
间日烦躁。渴饮。唇焦。舌黑。是内伏热气。由募原以流布三焦。亦如疟邪分争营
卫者然。然有年积劳既久。伏邪客病本轻。脉小缓。按之不无鼓击。可为征验。且
二便颇通。略能纳谷。焉有停滞积聚。仲景于瘅热无寒之条。不出药方。但曰。以
饮食消息。后贤参圣意。甘寒以养胃阴。其热自解。要知表散之辛温。消滞之苦
温。以及苦寒沉降。多犯圣训戒律矣。
鲜生地 甜杏仁 麦冬 花粉 竹叶心 青蔗汁 连翘
夏季温热上受。首先入肺。河间主三焦。极是。今世医者。初用非发散。即消
食。散则耗气。消则劫胃。究竟热蕴未除。而胃汁与肺气皆索。故不饥不食不便。
上脘似格似阻。酸浊之气。皆是热化。病延多日。苦寒难以骤进。先拟开提上焦气分。
苏子 杏仁 土栝蒌皮 枇杷叶 黄芩 降香
右侧偏头痛。鼻窍流涕。仍然不通畅。咽喉部有疳腐之症。醒后肢体发冷、出汗。这是外邪引起的头风。已经持续数月。病邪混杂停留。精华气血。都被蒙蔽闭塞。哪里是发散风寒可以解决的。头部用药。务必宜用轻清上扬之品。应当针刺风池穴和风府穴。投药仍以通法为主。如果不是气血周行不畅。怎么希望去除宿疾呢？
西瓜衣 鲜芦根 薏苡仁 通草 蜡矾丸
头部形象天。义理上不容受浊气。如今久痛且有高突的形状。似乎属于客邪蒙闭了清华的气血。然而长期服用桂枝、附子、紫河车。也没有见到害处。思考身体半以上属阳。而元首更是阳中之阳。大凡阳气先虚。清邪上入。气血瘀痹。疼痛连绵不息。治法应当宣通清阳。不要从事表散。用艾炷隔物灸或烙法治疗。也是一个道理。
熟半夏 北细辛 炮川乌 炙全蝎 姜汁
阳气被邪气阻滞。清空机窍不宣通。考察《周礼》采集毒药以攻治病邪。借助虫蚁在血中搜逐。来攻通邪结。这是古法但被医人忽略的。如今疼痛滋生于脑后。心下呕逆。这是厥阴经的症状。久病延及虚弱。攻邪须兼养正气。
川芎 当归 半夏 姜汁 炙全蝎 蜂房
风温从上而入。风属阳。温化为热。上焦侵犯肺。肺气不得舒展转输。周身气机受阻。导致身体疼痛、脘闷、不思饮食。宜用微苦以清降。微辛以宣通。医生说是六经病。就用羌活、防风。这会泄耗阳气。劫夺胃汁。温邪忌用汗法。为何这么快就忘记了。
杏仁 香豉 郁金 山栀 栝蒌皮 蜜炒橘红
劳倦嗔怒。是七情内伤。而温邪感触。气从口鼻直入膜原中道。大概伤寒阳症。邪气自太阳经次第传变。至于春温夏热。则鼻受气。肺受病。口入之气。竟由脘中进入。所以原有手经见症。不比伤寒足六经的病。其源不同。治法也异。仲景论述温邪不可发汗。汗则劫津伤阴。身体必然灼热。一误尚且拖延时日。再误则加速死亡。又说。鼻息鼾声。语言难出。剧则惊痫抽搐。无非是重劫津液所致。如今病发热。原本不是太阳客邪见症。所投羌活、防风。辛温表汗。这个错误就是逆证。上窍不纳。下窍不便。也是常事。必以攻下希图泄热。殊不知强汗劫津而伤阳。妄下劫液更亡阴。刚才诊脉。两手如搐而战。舌干燥而无苔。前板齿干。眼睛想闭。嘴巴想开。周身灯光照下显得淡晦。斑纹隐隐约约。这几天时有呃逆。因为胃乏谷气而中空。肝阳冲突。上冒肆虐耳。为今返正。先给糜粥。使胃中得濡润。厥阳不致上冒。而神昏的累赘可止。进药的道理。甘温可以生津除热。即使有斑疹也不足虑。看仲景论述中。邪少虚多。阴液阳津并涸者。复脉汤主之。谨仿此义。
炙甘草 人参 生地 白芍 阿胶 麦冬
温邪有升无降。经腑气机交逆。营卫失去常度。出现寒热。津液日耗。渴饮不思食。阳气独行。则头痛面赤。这都是冬春骤暖。天地失藏。人身应之。患此者最多。考察古人治温病忌表。误投即为劫津。逆传心包。最怕神昏谵语妄狂。治病以辛甘凉润为主。大概伤寒入足经。温邪入手经也。上润则肺降。不至于郁滞。胃热下移。知饥渴解矣。
嫩竹叶 桑叶 杏仁 蔗汁 麦冬 生甘草 石膏
久患虚损。原本寝食安舒。自己服用阴柔腻补。不但减食不寐。脘中常闷。渴欲饮凉。这是口鼻吸入温邪。先干于肺。误补则邪愈炽。气机阻塞。弱质不敢开泄。援引清扬肃上。兼以威喜丸。淡以和气。上焦得行。可用养胃法。
白沙参 薏苡仁 天花粉 桑叶 郁金 威喜丸
积劳伤阳卫疏。温邪上受。内入乎肺。肺主周身之气。气窒不化。外寒似战栗。其温邪内郁必从热化。如今气短胸满。病邪在上。大便泻出稀水。肺与大肠表里相应。也是由热迫下泄耳。用辛凉轻剂为稳。
杏仁 枯梗 香豉 橘红 枳壳 薄荷 连翘 茯苓
温邪中自口鼻。始而入肺为咳喘。继传膻中则呛血。乃心营肺卫受邪。然邪在上焦。壅遏阻气。必聚为热。痰臭呛渴。是欲内闭。可惜不以河间三焦立法。或谓伤寒主六经。或谓肺痈。或泄气血。致热无出路。胸突腹大。危期至速矣。即有对症药饵。气涌沸腾。势必涌吐无余。焉望有济。夫温热秽浊。填塞内窍。神识昏迷胀闷欲绝者。须以芳香宣窍。佐牛黄金箔。深入脏络。以收锢闭之邪。如今危笃若此百中图一而已。
紫雪丹
仲景说。阴气先伤。阳气独发。不寒瘅热。令人消烁肌肉。条例下不注方。只说。以饮食消息之。后贤说甘寒生津。解烦热。是对的。如今脉数。舌紫渴饮。气分热邪未去。渐次转入血分。这甘寒清气药中。必须佐存阴。为法中之法。
生地 石膏 生甘草 知母 粳米 竹叶心 白芍
温邪逆传膻中。热痰蔽阻空窍。所进寒凉消导。徒攻肠胃。毫无一效。痰乃热熏津液所化。膻中乃空灵之所。是用药之最难。至宝丹。芳香通其神明之窍以驱热痰之结。极是。但稚年受温邪。最易亏阴津耗。必须兼滋清。以理久伏温邪为正。
犀角 鲜生地 元参 连翘心 丹皮 石菖蒲 至宝丹
腹满已久。不是暴症。近日面颔肿胀。牙关紧闭。先有寒热。随现是象。诊脉右搏数。左小。乃温邪触自口鼻。上焦先受。气血与热胶固。致清窍不利。倏有痹塞之变。理当先治新邪。况头面咽喉结邪。必须辛凉轻剂以宣通。若药味重浊。徒攻肠胃矣。仿东垣普济消毒意。
连翘 牛蒡子 马勃 射干 滑石 夏枯草 金银花露 金汁
脉左数。右缓弱。阳根未固。阴液渐涸。舌赤微渴。喘促自利。溲数。晡刻自热。神烦呓语。夫温邪久伏少阴。古人立法。全以育阴祛热。但今见症。阴分固有伏邪。真阳亦不肯收纳。拟仿刘河间浊药轻投。不为上焦热阻。下焦根蒂自立。冀其烦躁热蒸渐缓。
熟地炭 茯苓 淡苁蓉 远志炭 川石斛 五味子
丰腴体质。适值过劳。阳气受伤。呕吐食物。无头痛身热。已非外感风寒。而间日烦躁。渴饮。唇焦。舌黑。是内伏热气。由募原以流布三焦。亦如疟邪分争营卫者然。然有年积劳既久。伏邪客病本轻。脉小缓。按之不无鼓击。可为征验。且二便颇通。略能纳谷。哪有停滞积聚。仲景于瘅热无寒之条。不出药方。只说。以饮食消息。后贤参圣意。甘寒以养胃阴。其热自解。要知表散之辛温。消滞之苦温。以及苦寒沉降。多犯圣训戒律矣。
鲜生地 甜杏仁 麦冬 花粉 竹叶心 青蔗汁 连翘
夏季温热上受。首先入肺。河间主三焦。极是。今世医者。初用非发散。即消食。散则耗气。消则劫胃。究竟热蕴未除。而胃汁与肺气皆索。故不饥不食不便。上脘似格似阻。酸浊之气。皆是热化。病延多日。苦寒难以骤进。先拟开提上焦气分。
苏子 杏仁 土栝蒌皮 枇杷叶 黄芩 降香
Right-sided headache. Nasal discharge from the nasal orifices. Still not feeling clear and unobstructed. Gangrenous decay in the throat. Upon waking, limbs are cold with sweating. This is exterior pathogenic wind-cold affecting the head (Toufeng). It has lingered for several months. The pathogen is mixed and stagnant. The essence, qi, and blood are all covered and blocked. How can dispersing wind-cold resolve this? Medications for the head must be light, clear, and ascending. Acupuncture at Fengchi (GB20) and Fengfu (GV16) should be performed. The prescription should still employ methods to unblock. Unless the circulation of qi and blood is restored, how can one hope to eliminate chronic diseases?
Watermelon Rind (Xigua Yi), Fresh Reed Rhizome (Xian Lugen), Coix Seed (Yiren), Tongcao Decoction (Tongcao), Wax-Alum Pill (Lafan Wan).
The head resembles Heaven; by principle, it cannot tolerate turbidity. Now, long-standing pain presents with a bulging appearance, suggesting that external pathogens are covering and blocking the pure and clear qi and blood. However, long-term consumption of Cinnamon Twig (Guizhi), Aconite (Fuzi), and Placenta (Heche) has not caused harm. Considering that the upper half of the body belongs to Yang, and the head is the "Yang among Yangs." Generally, if Yang qi is deficient first, clear pathogens enter upward, causing qi and blood stasis and obstruction, leading to persistent pain. The method should be to diffuse and unblock Clear Yang, avoiding superficial dispersion. Moxibustion using moxa cones on ginger or other mediums (Ai Jiu Luo An Fa) is also a valid approach.
Prepared Pinellia Tuber (Shu Banxia), Northern Asarum Root (Bei Xixin), Processed Sichuan Aconite Carried-over (Pao Chuanwu), Honey-fried Whole Scorpion (Zhi Quanxie), Ginger Juice (Jiangzhi).
Yang qi is obstructed by pathogens, and the clear orifices are not unblocked. Examining the *Rites of Zhou*, toxic medicines were collected to attack diseases, utilizing insects and ants to search and purge within the blood to break through pathogenic knots. This is an ancient method often ignored by physicians. Now, pain spreads to the back of the head, with nausea and vomiting below the heart, presenting symptoms of the Jueyin channel. Chronic illness leads to deficiency; attacking pathogens must simultaneously nourish Zheng Qi (Upright Qi).
Sichuan Lovage Rhizome (Chuanxiong), Angelica Sinensis Root (Danggui), Pinellia Tuber (Banxia), Ginger Juice (Jiangzhi), Honey-fried Whole Scorpion (Zhi Quanxie), Beehive (Fengfang).
Wind-heat enters from above. Wind belongs to Yang; heat transforms from warmth. The Upper Jiao invades the Lung. Lung qi fails to disperse and circulate, causing systemic qi stagnation, resulting in body pain, chest fullness, and loss of appetite. Slightly bitter flavors should be used to clear and descend; slightly acrid flavors to diffuse and unblock. Physicians attribute this to the Six Channels and prescribe Notopterygium Root (Qianghuo) and Saposhnikovia Root (Fangfeng), which leak Yang qi and rob Stomach fluids. Warm pathogens contraindicate sweating. Why is this forgotten so quickly?
Almond Seed (Xingren), Fermented Soybean (Xiangchi), Curcuma Aromatic Rhizome (Yujin), Gardenia Fruit (Shanzhi), Trichosanthes Peel (Gualou Pi), Honey-fried Tangerine Peel (Mihua Juhong).
Fatigue and anger constitute internal injury from the Seven Emotions. When contacted by warm pathogens, qi enters directly from the mouth and nose into the Membrane Source (Moyuan). In Cold Damage (Shanghan) Yang syndromes, pathogens transmit sequentially from the Taiyang channel. However, in Spring-Warmth and Summer-Heat, the nose receives qi and the Lung suffers disease; qi entering the mouth goes directly through the epigastrium. Thus, there are original Hand Meridian symptoms, unlike Foot Meridian diseases in Cold Damage. Their origins differ, so treatment methods differ. Zhang Zhongjing stated that warm pathogens must not be treated with sweating; sweating robs fluids and injures Yin, causing intense burning heat. One error prolongs the illness; a second accelerates death. He also noted: snoring breath, difficulty speaking, convulsions, and seizures in severe cases are all due to severe fluid depletion. Current fever is not a Taiyang exterior symptom. Prescribing Notopterygium and Saposhnikovia (acrid-warm diaphoretics) is an error constituting a "Ni" (counter-flow/adverse) syndrome. Upper orifices fail to receive; lower orifices fail to excrete. Attempting purgation to drain heat ignores that forced sweating injures Yang and reckless purgation injures Yin. Pulse feels like tremors in both hands. Tongue is dry without coating. Front teeth are dry. Eyes desire closure, mouth desires opening. Under lamplight, the complexion appears pale and dim. Spots are faintly visible. Hiccups occur intermittently due to Stomach lacking Grain Qi and being hollow. Liver Yang conflicts and assaults upward. To restore normalcy, first provide rice gruel to moisten the Stomach, preventing Jue Yang from assaulting upward and resolving confusion. Sweet-warm herbs generate fluids and clear heat; even with macules, there is little cause for concern. Following Zhang Zhongjing's principle for "less pathogen, more deficiency" with exhausted Yin and Yang fluids, use Fumai Tang (Restore the Pulse Decoction). Adhering to this meaning:
Honey-fried Licorice Root (Zhigancao), Ginseng Root (Renshen), Rehmannia Root (Shengdi), White Peony Root (Baishao), Donkey-hide Gelatin (Ejiao), Ophiopogon Tuber (Maidong).
Warm pathogens ascend but do not descend. Organ and Channel qi mechanisms reverse. Ying and Wei lose their normal rhythm, causing alternating chills and fever. Daily consumption of fluids leads to thirst and loss of appetite. Yang qi moves alone, causing headache and facial redness. These result from sudden warmth in Winter/Spring, disrupting Heaven and Earth's storage, affecting the human body. Many suffer thus. Ancient texts state treating warm diseases contraindicates superficial dispersion; errors rob fluids and transmit counter-currently to the Pericardium. The greatest fear is confusion, delirium, and mania. Treatment focuses on acrid-sweet-cool-moistening. Cold Damage enters Foot Meridians; Warm pathogens enter Hand Meridians. Moistening the upper allows Lung descent, preventing stagnation. Stomach heat moves downward, resolving hunger and thirst.
Young Bamboo Leaf (Nen Zhuye), Mulberry Leaf (Sangye), Almond Seed (Xingren), Sugarcane Juice (Zheshi), Ophiopogon Tuber (Maidong), Raw Licorice Root (Sheng Gancao), Gypsum (Shigao).
Long-standing deficiency originally had comfortable sleep and diet. Self-administered Yin-nourishing, cloying tonics reduced appetite and caused insomnia. Epigastric fullness and desire for cool drinks indicate warm pathogens inhaled via mouth/nose first drying the Lung. Mistaken tonification intensifies pathogens and blocks qi mechanism. Due to weak constitution, open release is avoided. Instead, use light, clear, descending herbs combined with Weixi Wan (Weixi Pill) to harmonize qi lightly. Once Upper Jiao flows, Stomach-nourishing methods can be used.
Amur Sandpearl Root (Baisha Shen), Coix Seed (Yiren), Trichosanthes Root (Tianhuafen), Mulberry Leaf (Sangye), Curcuma Aromatic Rhizome (Yujin), Weixi Pill (Weixi Wan).
Accumulated fatigue injures Yang and疏 (loosens) Wei. Warm pathogens enter from above into the Lung. Lung governs systemic qi. Qi stagnation fails to transform. Exterior cold mimics shivering. Internal warm pathogens must transform into heat. Shortness of breath and chest fullness indicate pathology in the Upper Jiao. Loose watery stool indicates Lung-Large Intestine interior-exterior correspondence, driven downward by heat. Using a Light Cool Diaphoretic formula is stable.
Almond Seed (Xingren), Dried Iris Rhizome (Kugen), Fermented Soybean (Xiangchi), Tangerine Peel (Juhong), Aurantium Fruit (Zhike), Mint Herb (Bohe), Forsythia Fruit (Lianqiao), Poria Sclerotium (Fuling).
Warm pathogens enter via mouth/nose, initially causing cough/asthma in the Lung, then transmitting to the Chest (Shanzhong) causing hemoptysis. Heart Ying and Lung Wei are affected. Pathogens in the Upper Jiao block qi, gathering as heat. Foul sputum, choking, and thirst indicate impending internal closure. Regrettably, Liu Wansu's Three Jiao legislation is not followed. Some attribute it to Cold Damage Six Channels, Lung Abscess, or Qi/Blood drainage, leaving heat with no exit. Chest protrusion and abdominal distension signal imminent danger. Even with correct medication, surging qi causes vomiting. For warm-heat turbidity filling internal orifices with confusion and suffocation, aromatic orifice-opening herbs assisted by Gold-leaf and Buffalo Horn (Niujin) are needed to penetrate organ collaterals and capture trapped pathogens. Critical condition; only 1 in 100 may survive.
Zixue Dan (Purple Snow Pill).
Zhang Zhongjing said: "Yin qi is injured first, Yang qi erupts alone. Not cold but intense heat, wasting muscles." No formula was provided, only "manage with diet." Later scholars advocated sweet-cold herbs to generate fluids and relieve irritability. Current rapid pulse, purple tongue, and thirst indicate Qi-level heat persists, gradually transitioning to Blood level. In sweet-cold Qi-clearing formulas, Yin-preserving herbs must be added as a method within a method.
Rehmannia Root (Shengdi), Gypsum (Shigao), Raw Licorice Root (Sheng Gancao), Anemarrhena Rhizome (Zhimu), Rice Grain (Jingmi), Bamboo Leaf Heart (Zhuyexin), White Peony Root (Baishao).
Warm pathogens counter-transmit to Shanzhong. Hot phlegm blocks empty orifices. Previous cold-cooling and digestion-promoting herbs only attacked the intestines/stomach with no effect. Phlegm is transformed from fluids steamed by heat. Shanzhong is an empty, spiritual space, making medication difficult. Zhibao Dan (Treasure of Ultimate Efficacy Pill) uses aromatics to open the spirit orifices and drive out hot phlegm knots. This is excellent. However, children contracting warm pathogens easily lose Yin fluids. Nourishing and clearing must be combined to address long-stagnant warm pathogens.
Rhinoceros Horn (Xijiao - *Note: Substitute with Water Buffalo Horn in modern practice*), Fresh Rehmannia Root (Xianshengdi), Scrophularia Root (Yuanshen), Forsythia Heart (Lianqiaoxin), Moutan Bark (Danpi), Acorus Rhizome (Shichangpu), Zhibao Dan (Treasure of Ultimate Efficacy Pill).
Abdominal fullness for a long time is not an acute syndrome. Recently, face/jaw swelling and trismus appeared after chills/fever. Right pulse is rapid; left is small. Warm pathogens entered via mouth/nose, affecting Upper Jiao first. Qi/blood and heat adhere, obstructing clear orifices, suddenly causing bi-obstruction. Treat new pathogens first. Head/face/throat pathogenic knots require Light Cool Diaphoretics to unblock. Heavy/turbid herbs only attack intestines/stomach. Following Li Dongyuan's Puji Xiaodu Decoction intent:
Forsythia Fruit (Lianqiao), Bullace Seed (Niubangzi), Moehringia Herb (Mabo), Belamcanda Rhizome (Shegan), Talcum (Huashi), Prunella Spike (Xiakucao), Honeysuckle Dew (Jinyinhua Lu), Human Excrement Juice (Jinzhi).
Left pulse rapid; right pulse slow/weak. Yang root is unstable; Yin fluids deplete. Red tongue, slight thirst, panting, spontaneous diarrhea, frequent urination, afternoon fever, mental restlessness, and muttering. Warm pathogens have long hidden in Shaoyin. Ancients used Yin-nourishing and heat-clearing methods. Current symptoms show latent Yin pathogens, but True Yang refuses to grasp. Mimicking Liu Hejian's "heavy medicine in light doses," avoiding Upper Jiao heat blockage, establishing Lower Jiao roots, hoping to ease restlessness and heat steaming.
Charred Prepared Rehmannia Root (Shudi Tan), Poria Sclerotium (Fuling), Cistanche Stem (Dan Congrong), Charred Polygala Root (Yuanzhi Tan), Dendrobium Stem (Chuan Shihu), Schisandra Berry (Wuweizi).
Plump constitution, overworked. Yang qi injured. Vomiting food. No headache/body heat, ruling out exterior wind-cold. Alternating day irritability, thirst, cracked lips, black tongue indicate internal latent heat spreading from Moyuan to Three Jiao, similar to Malaria pathogens contesting Ying/Wei. Long-term accumulation means latent pathogens are mild. Pulse small/slow, beating upon pressure confirms this. Bowels/bladder open, some food intake possible, ruling out stagnation/masses. Zhang Zhongjing gave no formula for "intense heat without cold," only "dietary management." Later scholars interpreted this as sweet-cold to nourish Stomach Yin, resolving heat. Acrid-warm dispersants, bitter-warm stagnation-breakers, and bitter-cold sinking agents violate these principles.
Fresh Rehmannia Root (Xianshengdi), Sweet Almond (Tian Xingren), Ophiopogon Tuber (Maidong), Trichosanthes Root (Huafen), Bamboo Leaf Heart (Zhuyexin), Green Sugarcane Juice (Qingzheshi), Forsythia Fruit (Lianqiao).
Summer warm-heat enters from above, first invading the Lung. Liu Wansu emphasized Three Jiao, which is correct. Modern physicians initially use dispersants or digestion aids. Dispersants consume Qi; digestion aids rob Stomach fluids. Heat remains, Stomach fluids and Lung Qi are depleted. Hence, no hunger, no eating, no bowel movement. Upper epigastria feels blocked. Sour/turbid qi results from heat transformation. After many days, bitter-cold cannot be introduced abruptly. First, lift and open Upper Jiao Qi mechanism.
Perilla Fruit (Suzi), Almond Seed (Xingren), Earth Trichosanthes Peel (Tu Gualou Pi), Loquat Leaf (Pipaye), Scutellaria Root (Huangqin), Costus Root (Jiangxiang).